先天性眼球震颤的手术治疗及对比敏感度在疗效评价中的作用  

Role of surgical treatment and contrast sensitivity in curative evaluation of congenital nystagmus

作　　者：布娟[1] 杜伟[1] 梁晨[1] 庞红蕾[1] 林淑芳[1] 王乐今[1] 

机构地区：[1]北京大学第三医院眼科,北京市100191

出　　处：《眼科新进展》2012年第1期37-39,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30950007)~~

摘　　要：目的研究改良Park术及眼外肌本体感受器切除联合眼外肌缩短术在治疗先天性眼球震颤中的疗效及对比敏感度检查在评价眼球震颤手术疗效中的作用。方法将82例先天性眼球震颤患者分为有中间带型(40例)和无中间带型(42例)两组。有中间带型眼球震颤患者施行改良的Park术,无中间带型眼球震颤患者施行眼外肌本体感受器切除联合眼外肌缩短术。所有患者术前及术后1个月给予双眼矫正视力及对比敏感度检查。结果所有患者术后眼位均为正位,且眼球转动各方向均不受限。40例有中间带型先天性眼球震颤患者术后1个月异常头位消失,第一眼位视力均较术前明显提高(P<0.05),均提高≥2行;对比敏感度在3周/度(cycle/degree,c·d-1)、6c·d-1、12c·d-1、18c·d-1空间频率下均较术前明显提高(均为P<0.05)。42例无中间带型先天性眼球震颤患者中,仅有7例患者双眼视力在术后1个月时提高≥2行(16.7%),但共有38例(90.5%)患者对比敏感度在各个空间频率上均较术前提高(均为P<0.05)。结论在改善先天性眼球震颤患者的异常头位及视功能方面,改良Park术与眼外肌本体感受器联合眼外肌缩短术具有良好的治疗效果;对比敏感度检查可用于客观评价先天性眼球震颤手术的效果。Objective To study the effect of improved Park＇s surgery and proprioceptor excision combined with extraocular muscle resection in treating congenital nystagmus（CN）,and observe the role of contrast sensitivity（CS） in curative evaluation.Methods Eighty-two patients with CN were divided into two groups.Improved Park＇s surgery was performed in 40 cases with gaze-null points.The proprioceptor excision combined with extraocular muscle resection was performed in 42 patients without gaze-null points.The corrected binocular visual acuity and CS were measured at pre-operation and postoperative 1 month.Results The eye positions of all patients were normal with no limited movement.The abnormal head positions were disappeared in 40 patients with gaze-null points at postoperative 1 month,the vision at the first eye position was higher than pre-operation（P0.05）;The CS at different frequency（3 c·d-1,6 c·d-1,12 c·d-1 and 18 c·d-1） were higher than pre-operation（all P0.05）.In 42 cases without gaze-null points,the vision in 7 cases（16.7%） increased at postoperative 1 month,CS in 38 cases（90.5%） at different frequency increased,there were statistical differences（all P0.05）.Conclusion For improving the abnormal head position and visual function,improves Park＇s surgery and proprioceptor excision combined with extraocular muscle resection has good curative effect on CN.CS can be used to evaluate the effects of nystagmus surgeries.

关 键 词：先天性眼球震颤 改良Park术 眼外肌本体感受器切除术 对比敏感度 

分 类 号：R777.46[医药卫生—眼科]